squishy 6/23

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sugarsquishy

sugarsquishy

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his numbers are staying in the 200 range. am i not giving him enough insulin. i thought the 1 whole unit was to much. maybe i should go back to the whole unit, or should i let the .8 unit go for a little bit to see how it is working?
 
Hi and a belated welcome,

Sorry I haven't been following your progress, so I may be asking some dumb questions, but

- what can we call YOU?

- I noticed an old post where you said you hadn't started using the u100 syringes. First, what is the strength of the "PZI" that you are using? BCP PZI I believe can be made u100 OR u40, and Prozinc is u40 insulin.

-IF you are using a u40 insulin, than you REALLY should start using the u100 syringes (WITH HALF UNIT MARKINGS) (SAMS $11) because you need to get more accurate in your dosing. It isn't clear to me how much insulin you are actually giving. If you are nervous about the conversion ASK for help, there have been lots of posts, pictures and help given on this topic. Some folks draw up water in the amount of a normal dose into a u40 syringe, squirt it into a spoon, and then draw it up into a u100 syringe, just to prove to themselves the correct conversion.

- It takes a little while for the insulin to settle in their systems, so that they get a little more duration. You will see the preshots typically higher because the duration is typically less than 12 hours. Keep up the good work!
 
his insulin is u40. i spoke with my vet today, and they told me not to use u100 needles. that there was no way to use them with u40 insulin. i have been talking with a local woman who has some u100 needles she is going to let me use. my vet will not give me an Rx for u100. i plan on meeting her later today to get those, and start using them tonight. and my name is Heather.
 
I ran into the u100 syringe resistance with my IM specialist. I explained the conversion and how it allowed microdosing. She still didn't like it and said she would post a question about it to some vet forum/email list she is a part of. I never heard back from her. Guess that means I was right lol. Even ProZinc manufacturer's website mentions the ability to use u100 syringes with their insulin under the faq section. They don't recommend it because of the chance on administering the wrong dose, but they do admit that it can be done with a conversion. (if you dose 2u via u100 instead of 2u via u40, you end up underdosing anyway - so not that great of a risk imo).

In regards to your numbers today - I don't think that is too fast of a drop, but thats just me. I would definitely test in an hour to see if he is going lower or on his way back up.
 
My vet got nervous about the U100 syringes too. So I just order them from Hocks & don't tell her now. ;-)

I don't think that drop is technically too much (i.e. hopefully it's not steep enough to trigger rebound - I have read they can tolerate up to about 100 pts/hour drop), but it is kind of intriguing, I don't know that I've ever seen the drop timed quite like that. Sign of Mr. P contributing? Or maybe resisting an earlier drop (which could be a sign the dose was too high) and this is sort of a late-ish drop (though not really late, hmmm). Not sure.

What makes me wonder though is the total drop from PS to nadir - I like around 60% drop, I think some say 70% is good. More than that is probably too steep IMO, so I'd say this is maybe the upper limit of what you'd want to see. I definitely wouldn't increase the dose, and if it were me, I'd probably shave just a hair off it and see how things go. But I can make an argument too for holding the dose steady and seeing how things settle out - sometimes they will get a varied response from cycle to cycle, so you can't always judge by one drop. I'd probably start with shaving a tiny bit off though, but I don't think there's a right answer necessarily.

You can base it too on whether or not you are around to monitor - stick with the dose if you know you can test and feed if needed to slow the drop, or reduce a hair if you won't be home to monitor. It's hard for me to predict the next cycle in this case - the dose was reduced so the #s could get higher with each cycle, but then this cycle was better than the last couple, so that could mean the dose wasn't too high before, but now it is (liver getting trained, or Mr. P contributing could mean the insulin need is going down). I'm just not 100% sure what to make of it. That's why for me I'd lean towards reducing a hair & see what happens.

Regardless though, the green #s are DEFINITELY a good thing! :mrgreen:
 
Hi Heather,

Its always nice to know who your talking to!

Here is the conversion chart link: http://www.felinediabetes.com/insulin-conversions.htm
I found it IN the sticky at the top of the PZI ISG forum, titled : "Please read First Before posting the First Time" If you google it, you will also find it in several places online. It is commonly done, I think most of the U40 moms use u 100 syringes. I totally understand your nervousness. You just need to talk it out with a number of folks that do it ( I'm not one of them because my cat has acromegaly and uses super high doses as a result. Actually now we are using a u100 insulin, so I use u100 syringes- but obviously no conversion)

If for example, you would like to hold a steady .8u dose for 3-5 days, it looks to me like that would mean you draw to the 2unit mark on a u 100 syringe. Am I reading this right folks?-- those of you who use them please chime in.... When you are writing about it online, you ALWAYS refer to the dose as .8u (not 2u).

PLease make sure you test it, with water in a spoon like I described above, to feel comfortable that you are correct, before you inject kitty.

BTW you do NOT need a prescription to buy u100 syringes at a pharmacy. If they ask, you are buying them for your diabetic cat.

While you are there, you might also pick up some ketostyx to test urine for ketones. Others please chime in...
 
Hey Heather aka Mama of Squishy!

It sounds like he's right in a perfect pocket at that dose. The nadir in the 80's is fabulous!! He seems to be holding steady and keeping him under 230 (which is one of the many #'s that are said to be the renal threshold - always the one we used) will help him heal. I also recommend the U100's. I ordered them online at Hock's as well. If there's a problem getting them without a prescription (even online) I'm sure we can find a way around that.

Also, when I got them at my vet, they were WAY overpriced and didn't have the 1/2 unit markings. I truly don't know how you can dose with ProZinc without the U100's. ECID, but a .2 unit change made a HUGE difference with our cat.
 
Hi Heather!

This dose looks good, and since you are going to be switching to the u100 syringes tonight (I assume?) I wouldn't try to adjust the dose. It will be enough of a change of dose just switching the syringe, so I would start with whatever dose you think it was with the u40 syringes (0.8u?) and try to stick with it for a couple of cycles. Of course, if the nadir drops low, I would decrease on the next shot, as always. As Hope said, tiny dose adjustments work best with ProZinc, so the u100s will make it possible to make those 0.1-0.2 changes with good accuracy. The 82 nadir looks good, love those green #s!
 
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